CoxHealth Begins Push to Help Doctors Make Better Choices When Prescribing Opiates

Oct 2, 2017

CoxHealth brought an educator to the Keeter Center at College of the Ozarks on Friday to give advice to area prescribers.  Dr. Ted Parran, an internal medicine physician and professor at Case Western Reserve University School of Medicine, presented a systematic approach to assessing whether or not it’s safe to prescribe controlled drugs to a patient.

He said physicians must play a key role in addressing the public health crisis that prescription drug abuse has become.

"We need to stop prescribing opiates and other controlled drugs to patients with a substance abuse history," he said.  "We just have to say no."

According to Dr. Parran, physicians and other prescribers need to put the best interest and the safety of the patient above the patient’s complaints of pain.  He offered advice about how to tell a patient no while reducing the chances of anger directed toward the physician.  What he calls "pearls to use" include:  support, "I want to work with you;" optimism, "you can and will get better;" absolution, "it is not your fault for having the illness, just your responsibility to manage it;" plan, which he said depends on the patient's readiness for change; and explanatory model, "this can be hard to hear.  What are your thoughts about your substance use?"

Dr. Bryan Finke, medical director for CoxHealth’s Population Health Department, said 80 percent of people using heroin and other street drugs started with a prescription from a healthcare provider.

"So, to educate health providers to give the right prescriptions at the right time to the right patients in limited amounts, safely--decrease the amount of prescriptions, is actually going to decrease heroin and illicit substance uses," said Finke.

He said prescribers need to work together to police themselves and to continue to keep pressure in the legislature to come up with a state solution to the problem and to help them be better prescribers.  He’s optimistic the new statewide Prescription Drug Monitoring Program as well as one in Springfield, once they’re implemented, will allow them to “keep patients safe.”

CoxHealth taped Dr. Parran’s session, and it will be made available to prescribers throughout the healthcare system.